POS0024 RETENTION RATE OF TNF INHIBITORS (TNFI), ANTI-IL17, AND ANTI-IL12/23 DRUGS IN A SINGLE-CENTER COHORT OF PSORIATIC ARTHRITIS PATIENTS
Authors: M. Ferrito, G. Cincinelli, M. Manara, E. G. Favalli, R. Caporali
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> During the last decades, it has been proposed to widen the horizons of psoriatic patients under a broader clinical concept of psoriatic disease (PD) encompassing both articular and extra-articular features. The most recent international recommendations on psoriatic arthritis (PsA) management highlight the need to personalize therapeutic strategies based on articular and extra-articular manifestations, such as axial or peripheral involvement and severity of skin psoriasis. Lacking specific recommendations for PsA comorbidities treatment, management decisions are often driven by drugs safety profiles and experience gathered from other rheumatologic diseases, such as rheumatoid arthritis. In the last years, new drugs have been approved for PsA management, expanding the possibility to personalize treatment choice in patients with PsA. <h3>Objectives</h3> Our study aims at evaluating the retention rate of bDMARDs with different mechanism of action (MoA) (TNFi vs non-TNFi) and factors associated with drug suspension in a single-center cohort of PsA patients. Furthermore, we aim to investigate whether demographic and clinical factors (among which comorbidities) could drive the choice of bDMARDs between TNFi and non-TNFi. <h3>Methods</h3> A retrospective cohort from a single-center real-word clinical setting has been collected. A total of 241 bDMARDs therapy courses (155 TNFi drugs, 65 anti-IL-17 drugs, and 21 anti-IL12/IL-23) were analyzed. Bivariate analyses were performed to assess the presence of demographic and clinical features, as well as comorbidities, associated with bDMARDs discontinuation in the TNFi and non-TNFi groups. Further, we conducted survival analysis and Cox regression, in order to individuate the possible predictors of failure among patients receiving TNFi and non-TNFi. <h3>Results</h3> In the bivariate analyses of TNFi and non-TNFi groups we found a lower age at TNFi start (46 years, IQR 45-54 vs 50.5 years, IQR 42-61; p=0.004) as well as a lower proportion of patients with skin psoriasis (65.8% vs 88.4%, p&lt;0.001). Survival analysis showed no significant differences between TNFi and non-TNFi groups. Cox regression individuated fibromyalgia as a predictor of drug failure (HR 3.40, 1.92-6.03; p&lt;0.001) and first line bDMARDs as protective factor (HR 0.46, 0.25-0.88; p=0.019). Lastly, among TNFi courses, fibromyalgia was associated with drug suspension (HR 6.52, 3.16-13.46; p&lt;0.001), while only a trend of significance for skin psoriasis as risk factor for drug failure was shown (HR 2.38, CI 1.00 - 5.66, p=0.05). <h3>Conclusion</h3> This study provides information about clinical and demographic factors associated with retention rates of bDMARDs from a real-life, single-center cohort of PsA patients. In our study, TNFi and non-TNFi drugs had similar retention. Fibromyalgia and skin psoriasis seem to be the major predicted of drug discontinuation; in contrast, a lower failure risk has been observed in first-line treatment course. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Matteo Ferrito: None declared, Gilberto Cincinelli: None declared, Maria Manara Speakers bureau: Novartis, Angelini, Consultant of: Lilly, MSD, Ennio Giulio Favalli Speakers bureau: AbbVie, BMS, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, UCB, Consultant of: AbbVie, BMS, Celltrion, Galapagos, Janssen, Lilly, MSD, Novartis, Pfizer, UCB, Roberto Caporali Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Fresenius, Galapagos, Janssen, Lilly, Novartis, Pfizer, UCB, Consultant of: AbbVie, Fresenius, Galapagos, Lilly, Novartis, Pfizer, UCB.